Healthcare Provider Details

I. General information

NPI: 1780068742
Provider Name (Legal Business Name): NATASHA DAWN WAMSLEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2015
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 COOMBS FARM RD STE 106
MORGANTOWN WV
26508-1157
US

IV. Provider business mailing address

10000 COOMBS FARM RD STE 106
MORGANTOWN WV
26508-1157
US

V. Phone/Fax

Practice location:
  • Phone: 304-212-5663
  • Fax:
Mailing address:
  • Phone: 304-212-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN76820
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: